Les antibiotiques (ATB) inhibent l'efficacité anti-tumorale du blocage de PD1, mais les mécanismes sous-jacents à leurs effets immunosuppresseurs demeurent inconnus. Nous montrons ici que les ATB favorisent l'accumulation des cellules T FoxP3+ et RORct+ a4b7hi dans les ganglions lymphatiques et les lésions tumorales. Les ATB induisent la perte de l'adressine MadCAM-1 iléale provoquant la recirculation des lymphocytes T régulateurs et TH17 α4β7hi de l’iléon vers le microenvironnement tumoral (TME). Cette migration a été visualisée grâce à 2 méthodes, la première consiste en l’ injection directe de carboxyfluoresceine succinimidyl ester (CFSE) dans les ganglions lymphatiques mésentériques des souris porteuses de tumeurs, l’autre utilise des souris transgéniques Kaede contenant une protéine flurorescente photoconvertible. Les hétérodimères d'adressine MAdCAM-1 et d'intégrine α4β7 sont indispensables pour l'efficacité anti-tumorale et dans l'immuno-surveillance induite par les anticorps anti-PD1. L’utilisation de modèles knock-out de MadCAM-1 ou d’ anticorps bloquant son ligand α4β7, compromettent l’efficacité anticancéreuse du blocage du PD1 ceci en mobilisant les cellules entérotropes α4β7hi Treg et TH17 vers le TME et inversement, en réduisant le retour du Treg du TME vers l'intestin. L’inhibition de la voie MadCAM-1 au niveau iléal réduit simultanément les lymphocytes CCR5+ effecteurs et mémoires dans le tissu tumoral. Ces résultats démontrent l’existence d’un lien mécanistique entre la dysbiose intestinale et l'efficacité du traitement anti- tumoral, l’importance de l'axe intestin-tumeur dans l’ immunosurveillance du cancer et ouvre des perspectives d’application clinique pour cibler la voie MAdCAM-1 α4β7+ . / Antibiotics (ATB) inhibit the anticancer efficacy of PD1 blockade but the mechanisms underlying their immunosuppressive effects remains unknown. Here we show that ATB promote the accumulation of enterotropic, ileum egressing FoxP3+ and RORct+ α4β7 hi T cells into tumor draining lymph nodes and tumor lesions. ATB induce the loss of ileal MadCAM-1 adressin provoking the recirculation of α4β7 hi ileal Treg and TH17 cells to the tumor microenvironment (TME), as visualized using direct injection of carboxyfluorescein succinimidyl ester in mesenteric lymph nodes of tumor bearers as well as Kaede transgenic mice harboring a photoconvertible flurorescent protein. MAdCAM-1 addressin and α4β7 integrin heterodimers are indispensable for the anticancer efficacy and the immuno-surveillanc elicited by anti-PD1 antibodies. Gene defects in MadCAM-1 as well as antibodies blocking its ligand α4β7, severely compromise the anticancer effects of PD1 blockade by mobilizing enterotropic α4β7hi Treg and TH17 cells towards the TME and conversely reducing Treg homing from the TME to the gut, concomitantly reducing CCR5+ effector memory tumor infiltrating lymphocytes. These findings demonstrate a mechanistic link between gut dysbiosis and tumor treatment efficacy and unveil the potential clinical relevance of the MAdCAM-1 α4β7+ and the gut-tumor axis in cancer immunosurveillance.

L'infection par le (virus de l'immunodéficience humaine) VIH est caractérisée par une déplétion sévère et massive, précoce des T CD4+ dans l'intestin. Les mécanismes à l'origine de cette déplétion sont imparfaitement connus, mais la conséquence de cette atteinte muqueuse est une activation chronique du système immunitaire liée à la translocation microbienne. Surtout, cette atteinte semble irréversible malgré le contrôle efficace de la réplication virale à long terme.La translocation microbienne, causée par l'infection à VIH, établit une activation immunitaire chronique dans l'intestin, et cela a un impact grave sur la reconstitution des cellules T CD4 + et de leurs fonctions. Cependant, on ne sait pas si les dommages de la muqueuse intestinale peuvent être restaurés à un niveau normal grâce à l'intervention thérapeutique, et les facteurs déterminants qui influenceront T CD4 + restauration cellulaire n'ont pas été identifiés.En induisant une défense de la muqueuse contre les agents pathogènes microbiens dans l'intestine et le maintien de l'intégrité intestinale de l'épithélium, les cellules Th17+T CD4 + nouvellement caractérisé orchestrent l'immunité muqueuse. Une perte de cellules Th17 a été observée dans infections par le VIH et l'immunodéficience simien virale (SIV) et conduit à une défense immunitaire altérée contre les agents pathogènes microbiens entrants et, en conséquence, la diffusion systémique des agents pathogènes.Dans cette étude, j'ai cherché à mieux comprendre les déterminants de la restauration de la muqueuse intestinale afin de répondre à la question si leur fonction peut être restaurée au cours de traitement antirétroviral (combined antiretroviral therapy, cART) tôt initié.Analyse phénotypique et l'expression des gènes ont été effectués à partir de l'intestin de patients naïfs infectés par le VIH ou les patients initiés au traitement de cART soit à la phase précoce de l'infection primaire, ou plus tard au cours de la phase chronique. Ces données démontrent une diminution de la muqueuse Th22 et IL-17 cellules produisant chez les patients naïfs. Ces populations, à l'exception des cellules Th22, n'ont pas été restaurées sous cART. Le rapport Treg/Th17 a été significativement augmentée chez les patients infectés par le VIH et a été inversement corrélée avec la restauration des cellules T CD4 +, mais pas avec des niveaux d'ADN du VIH dans l'intestin. Les analyses d'expression génique profilage de la muqueuse intestinale distingué deux groupes de patients, qui a coïncidé avec le moment de l'initiation du cART. La majorité de début traitée, mais pas les patients traités plus tard a montré une structure conservée intestinale lymphoïde, l'intégrité de la barrière épithéliale et dendritiques voies de maturation cellulaire. Dans l'ensemble, ces résultats démontrent que l'initiation précoce d'antirétroviraux contribue à préserver et / ou restaurer l'homéostasie lymphoïde de la muqueuse intestinale et donc fournir une justification pour lancer cART au cours de la phase aiguë de l'infection par le VIH. / Human Immunodeficiency Viral (HIV) infection leads to a severe and massive CD4+T cell depletion in the gut associated lymphoid tissue (GALT) very early during the course of viral infection. This depletion, which is not reflected in peripheral blood, persists despite the initiation of combined antiretroviral therapy (cART). The loss of lamina propria CD4+T cells, changes in the lymphatic architecture and altered intestinal epithelial barrier leading to microbial translocation are the common features of HIV-1 infection and are not fully restored under cART.Microbial translocation, caused by HIV infection, establishes a chronic immune activation, and this has a severe impact on the reconstitution of CD4+T cells and their functions. However, it is not known whether gut mucosal damage can be restored to normal levels through therapeutic intervention, and the determining factors that would influence CD4+T cell restoration have not been identified.By inducing a mucosal defense against microbial pathogens in GALT and maintaining the gut epithelial integrity, newly characterized Th17 CD4+T cells orchestrate the mucosal immunity. A loss of Th17CD4+T cells has been observed in HIV and Simian Immune Deficiency Viral (SIV) infections and leads to an impaired immune defense against incoming microbial pathogens and, as a consequence, systemic dissemination of pathogens.In this study, we analyzed parameters of gut mucosal restoration in order to answer the question if their function can be restored during early initiated cART.Phenotypic and gene expression analyses have been performed from the gut of HIV-infected naïve patients or patients treated for several years. We analyzed 2 groups of treated patients, one initiated cART treatment at the early phase of the primary infection, the second during the chronic phase. These data demonstrate a depletion of mucosal Th22 and IL-17 producing cells in naive patients. These populations, except Th22 cells, were not restored under cART. The Treg/Th17 ratio was significantly increased in HIV infected patients and was inversely correlated with the restoration of CD4+T cells, but not with HIV DNA levels in the gut. Gene expression profiling analyses of gut mucosal distinguished two groups of patients, which coincided with the timing of cART initiation. The majority of early treated, but not later treated patients exhibited a conserved intestinal lymphoid structure, epithelial barrier integrity and dendritic cell maturation pathways. Overall, these results demonstrate that early initiation of cART helps to preserve and/or restore lymphoid gut mucosal homeostasis and thus provide a rationale for initiating cART during the acute phase of HIV infection.

A better understanding of these structural changes that occur before Hypertension (HTN) could ultimately result in a treatment that can prevent or reverse this disease state before its onset. T cells have been shown essential for the development of HTN. The aim of these murine studies was to investigate the role of the T-helper CD4⁺ lymphocytes in initiating vascular remodeling and HTN in the absence of an increased mechanical load and to investigate the role of T-helper 17 (Th17) CD4⁺ lymphocyte initiating vascular remodeling and HTN by stimulating Lysyl Oxidase (LOX). LOX is known to cross-link collagen and elastin and. Excess synthesis of collagen and elastin results in a stiffer artery and hypertension. We established L-NAME-induce HTN in wild type (WT) mice. CD4⁺ splenic lymphocytes were isolated from these mice and adoptively transferred into naïve syngeneic severe combined immunodeficient (SCID) mice. The SCID mice receiving these cells became hypertensive. Cytokine analysis demonstrated an increase in both Th1 and Th17 cytokine in HTN donor mice and of lymphocytes in the aortic infiltrates of the HTN recipient mice. The increased collagen and LOX expression in recipient mice suggest that the adoptively transfer CD4⁺ lymphocytes are associated with vascular extracellular matrix remodeling. Furthermore we examined the role of Th17 lymphocyte in aortic LOX regulation in Angiotensin II-induced hypertension. The Increase in blood pressure and Velocity Time Integral (VTI) was measured in WT Angiotensin II treated mice whereas no change was detected in the Th17 deficient (RORT KO) Angiotensin II treated group. When compared to the control group the WT group infused with Angiotensin II had higher LOX protein expression, LOX fluorescent Immunohistochemical stain and LOX activity. This group also had increased hydroxyproline levels, collagen stain, hyperplasia and aortic thickening. In contrast, the Th17 deficient mice Angiotensin II treated group had no changes in these parameters. The results provide evidence that IL-17 mediates Angiotensin II-induced hypertension and vascular dysfunction by the overstimulation of LOX. Potentially targeting T17 cells will allow for a drug-specific therapeutic approach and delay the progression of hypertension pathology.

L'inflammasome est complexe protéique intracellulaire de l'immunité innée permettant la reconnaissance de pathogènes intracellulaires. NLRC4, un Nod-like récepteur permettant l'activation de l'inflammasome est impliqué dans la reconnaissance du flagelle ainsi que du système de sécrétion de type 3 (SST3) de Pseudomonas aeruginosa, une bactérie majoritairement extracellulaire. Nous avons donc déterminer l'impact de la reconnaissance de P. aeruginosa par le NLRC4-inflammasome in vivo dans un modèle murin de pneumonie aiguë. De façon surprenante, l'activation du NLRC4-inflammasome par le SST3 de P. aeruginosa contribue à diminuer la survie de l'hôte en diminuant la clairance bactérienne pulmonaire et en augmentant la lésion pulmonaire induite. En effet, la perte de l'activation de l'inflammasome chez les souris NLRC4/- permet d'une part, une réponse précoce méfiée par l'IL-17A. Cette réponse dépendant de l'IL-17A conduit à une expression majeure de peptides antimicrobiens par l'épithélium pulmonaire et diminue la lésion pulmonaire en diminuant le recrutement des cellules immunitaires inflammatoires. L'administration d'IL-18 recombinante murine ou l'inhibition de cette voie par un anticorps anti-IL-17A inhibe cette réponse IL-17A dépendante. Ces résultats mettent en évidence un nouveau rôle du SST3 de P. aeruginosa, qui en plus de son effet cytotoxique et de la translocation d'exotoxines, permet d'activer l'inflammasome pour échapper à la réponse immunitaire innée de l'hôte en inhibant une voie IL-17 dépendante. / The inflammasome is thought to function as a cytosolic surveillance system against intracellular pathogens. However, we report that Pseudomonas aeruginosa, an extracellular pathogen responsible for acute lung infection, relies upon inflammasome activation to persist and worsen disease. Specifically, we show that loss of either NLRC4 expression or type-3 secretion system (T3SS)-driven activation of NLRC4, surprisingly, resulted in a robust Th-17-like immune response that enhanced bacterial clearance and attenuated virulence independently of exotoxins. This Th-17-like response correlated with marked upregulation of antimicrobial peptides and was suppressed by either neutralization of IL-17A or exogenous IL-18 administration in vivo. Together, these results unveil an adaptation mechanism through which the problem pathogen manages to evade Th17-mediated immunity and invade the lung, providing a potential mechanism for infectious complications of anti-IL17 therapy in inflammatory diseases. The T3SS exploitation of NLRC4-coupled inflammasome response may therefore represent a novel gene-for-gene model of pathogen evolution alongside host immunity.

Ankylosing spondylitis (AS) is a common inflammatory arthritis of the spine and other affected joints, which is highly heritable, being strongly influenced by the HLA-B27 status, as well as hundreds of mostly unknown genetic variants of smaller effect. The aim of my research was to confirm some of the previously observed genetic associations and to identify new associations, many of which are in biological pathways relevant to AS pathogenesis, most notably the IL-23/T_H17 axis (IL23R) and antigen presentation (ERAP1 and ERAP2). Studies presented in this thesis include replication and refinement of several potential associations initially identified by earlier GWAS (WTCCC-TASC, 2007 and TASC, 2010). I conducted an extended study of IL23R association with AS and undertook a meta-analysis, confirming the association between AS and IL23R (non-synonymous SNP rs11209026, p=1.5 x 10-9, OR=0.61). An extensive re-sequencing and fine mapping project, including a meta-analysis, to replicate and refine the association of TNFRSF1A with AS was also undertaken; a novel variant in intron 6 was identified and a weak association with a low frequency variant, rs4149584 (p=0.01, OR=1.58), was detected. Somewhat stronger associations were seen with rs4149577 (p=0.002, OR=0.91) and rs4149578 (p=0.015, OR=1.14) in the meta-analysis. Associations at several additional loci had been identified by a more recent GWAS (WTCCC2-TASC, 2011). I used in silico techniques, including imputation using a denser panel of variants from the 1000 Genomes Project, conditional analysis and rare/low frequency variant analysis, to refine these associations. Imputation analysis (1782 cases/5167 controls) revealed novel associations with ERAP2 (rs4869313, p=7.3 x 10-8, OR=0.79) and several additional candidate loci including IL6R, UBE2L3 and 2p16.3. Ten SNPs were then directly typed in an independent sample (1804 cases/1848 controls) to replicate selected associations and to determine the imputation accuracy. I established that imputation using the 1000 Genomes Project pilot data was largely reliable, specifically for common variants (genotype concordence~97%). However, more accurate imputation of low frequency variants may require larger reference populations, like the most recent 1000 Genomes reference panels. The results of my research provide a better understanding of the complex genetics of AS, and help identify future targets for genetic and functional studies.